Purpose: To identify predictive factors for vasopressor (VP) requirement post-adrenalectomy for phaeochromocytoma (PHAEO) Methodology: A retrospective cohort study was undertaken at a tertiary centre. Patient demographics, co-morbidity score, pre-operative symptoms, pre-operative plasma and urinary catecholamine levels, medications and surgical approach, were analysed for patients undergoing surgery for PHAEO in the period 2013-2022. The primary outcome measure was requirement for VP in the post-operative period. Multivariate analysis was performed. Results: 105 patients (female n=60, 57%) underwent surgery for PHAEO in the period 2013-2022. The median age was 50yr and median BMI24. 91% of patients were ASA grade ≥ 3, 19% had an underlying causative genetic condition. 18% of patients presented as an adrenal incidentaloma, six patients had bilateral tumours. The median tumour size was 4.8cm, 5% were malignant. Post-operatively, 36% of patients required VP support within the first 24 hours. Elevated plasma normetanephrines were associated with a significantly increased rate of VP requirement post-operatively (OR 2.2, p<0.05). Patients undergoing open surgery had a higher incidence of VP requirement (OR 2.7, p<0.05). Symptomatic patients had a higher rate of VP use compared with those presenting as incidentaloma (p<0.05). The use of pre-operative alpha blockade, pre-operative mean arterial pressure, patient co-morbidities, underlying genetic condition and the presence of metastasis were not significant predictors of VP requirement. Conclusion: In PHAEO patients, pre-operative symptoms, elevated plasma normetanephrines and open adrenal surgery are associated with a significantly higher rate of VP requirement in the post-operative period.